Using crowdsourcing to examine behavioral economic measures of alcohol value and proportionate alcohol reinforcement

Applying behavioral economics to understand changes in alcohol outcomes during the transition to adulthood: Longitudinal relations and differences by sex and race

OBJECTIVE

Population drinking trends show clear developmental periodicity, with steep increases in harmful alcohol use from ages 18 to 22 followed by a gradual decline across the 20s, albeit with persistent problematic use in a subgroup of individuals. Cross-sectional studies implicate behavioral economic indicators of alcohol overvaluation (high alcohol demand) and lack of alternative substance-free reinforcers (high proportionate alcohol-related reinforcement) as potential predictors of change during this developmental window, but longitudinal evidence is sparse.

METHOD

Using a sample of emerging adults (N = 497, Mage = 22.61 years, 62% female, 48.69% White, 40.44% Black), this study examined prospective, bidirectional relations between both past-week heavy drinking days (HDD) and alcohol problems and proportionate alcohol-related reinforcement (reinforcement ratio), alcohol demand intensity (consumption at zero price), alcohol demand Omax (maximum expenditure), and change in demand elasticity (rate of change in consumption across escalating price) over five assessments (every 4 months) using random intercept cross-lagged panel models.

RESULTS

Alcohol problems and HDD decreased across assessments. Significant between-person effects indicated that each behavioral economic variable was associated with increased drinking risk. Change in reinforcement ratio was positively associated with decreases in alcohol problems. Multigroup invariance modeling revealed distinct risk pathways in that change in demand intensity and Omax predicted change in alcohol problems for male participants and change in intensity predicted change in alcohol problems for non-White participants.

CONCLUSION

The study provides consistent support for proportionate alcohol-related reinforcement and mixed support for demand as within-person predictors of reductions in drinking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Attention-deficit/hyperactivity disorder is associated with more alcohol problems and less substance-free reinforcement: A behavioral economics daily diary study of college student drinkers

OBJECTIVE

Behavioral economic theory suggests that alcohol risk is related to elevated alcohol reinforcing efficacy (demand) combined with diminished availability of reinforcing substance-free activities, but little research has examined these reward-related processes at the daily level in association with comorbid conditions that might influence behavioral patterns and reward. Young people with attention-deficit/hyperactivity disorder (ADHD) report high levels of risky drinking, and this risk may be due in part to elevated demand for alcohol and diminished engagement in enjoyable and valued substance-free activities.

METHOD

College student drinkers (N = 101; 48.5% female; 68.3% White; 18-22 years old) with (n = 51) and without (n = 50) ADHD completed 14 consecutive daily diaries (diary entry n = 1,414). We conducted a series of multilevel path models to examine (a) the associations among ADHD and average daily alcohol demand, substance-free enjoyment, and response contingent positive reinforcement (RCPR) for goal-directed behaviors; (b) the associations among concurrent daily alcohol demand, substance-free reinforcement, and RCPR for goal-directed behaviors and daily alcohol use and alcohol-related negative consequences; and (c) the moderating effect of ADHD on these within-day associations.

RESULTS

ADHD was significantly associated with more daily alcohol-related negative consequences and less daily substance-free enjoyment and RCPR. Regardless of ADHD status, there were significant associations among behavioral economic risk factors and alcohol use and negative consequences, though effects differed within and between persons. There were no moderating effects of ADHD on within-person associations.

CONCLUSIONS

Results expose areas of impairment specific to drinkers with ADHD and advance theory on ADHD and hazardous drinking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Crowdsourcing with the drift diffusion model of decision making

Crowdsourcing involves the use of annotated labels with unknown reliability to estimate ground truth labels in datasets. A common task in crowdsourcing involves estimating reliabilities of annotators (such as through the sensitivities and specificities of annotators in the binary label setting). In the literature, beta or dirichlet distributions are typically imposed as priors on annotator reliability. In this study, we investigated the use of a neuroscientifically validated model of decision making, known as the drift-diffusion model, as a prior on the annotator labeling process. Two experiments were conducted on synthetically generated data with non-linear (sinusoidal) decision boundaries. Variational inference was used to predict ground truth labels and annotator related parameters. Our method performed similarly to a state-of-the-art technique (SVGPCR) in prediction of crowdsourced data labels and prediction through a crowdsourced-generated Gaussian process classifier. By relying on a neuroscientifically validated model of decision making to model annotator behavior, our technique opens the avenue of predicting neuroscientific biomarkers of annotators, expanding the scope of what may be learnt about annotators in crowdsourcing tasks.

Internal Consent, Affirmative External Consent, and Sexual Satisfaction Among Young Adults

Sexual satisfaction is an important part of sexual health. Recently, efforts have been underway to better understand what factors contribute to positive sexual experiences among young adults. One factor may be sexual consent. This study aimed to explore individual and interactive effects of two distinct, but related dimensions of sexual consent - internal consent and affirmative external consent - on young adults' feelings of sexual satisfaction following their most recent sexual intercourse experience. Participants were 294 young adults (ages 18-25, Mage = 23.7; 59% women) recruited from Amazon's MTurk. Results showed that each dimension of consent had a significant, unique relationship with satisfaction, and that the two dimensions of consent alone accounted for half of the variance in satisfaction. Additional analyses showed that there are specific components of both internal and affirmative external consent (e.g., safety/comfort; arousal; consent/want; communicator/initiator cues) that may be most influential in driving this relationship. As both consent dimensions greatly contribute to positive sexual experiences, researchers attempting to promote sexual wellbeing may be wise to attend to both internal and external consent.

Measuring psychiatric symptoms online: A systematic review of the use of inventories on Amazon Mechanical Turk (mTurk)

Symptom measurement in psychiatric research increasingly uses digitized self-report inventories and is turning to crowdsourcing platforms for recruitment, e.g., Amazon Mechanical Turk (mTurk). The impact of digitizing pencil-and-paper inventories on the psychometric properties is underexplored in mental health research. Against this background, numerous studies report high prevalence estimates of psychiatric symptoms in mTurk samples. Here we develop a framework to evaluate the online implementation of psychiatric symptom inventories relative to two domains, that is, the adherence to (i) validated scoring and (ii) standardized administration. We apply this new framework to the online use of the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Alcohol Use Disorder Identification Test (AUDIT). Our systematic review of the literature identified 36 implementations of these three inventories on mTurk across 27 publications. We also evaluated methodological approaches to enhance data quality, e.g., the use of bot detection and attention check items. Of the 36 implementations, 23 reported the applied diagnostic scoring criteria and only 18 reported the specified symptom timeframe. None of the 36 implementations reported adaptations made in their digitization of the inventories. While recent reports attribute higher rates of mood, anxiety, and alcohol use disorders on mTurk to data quality, our findings indicate that this inflation may also relate to the assessment methods. We provide recommendations to enhance both data quality and fidelity to validated administration and scoring methods.

Associations between Alcohol-Free Sources of Reinforcement and the Frequency of Alcohol and Cannabis Co-Use among College Freshmen

Co-use of alcohol and cannabis is common among young adults in the United States. A behavioral economics framework indicates that greater engagement in substance-free sources of reinforcement may be protective against co-use frequency. The current study tested the association between proportionate alcohol-free reinforcement and the frequency of co-use among college freshmen. Participants (N = 86) were freshmen who enrolled in a freshman orientation course and completed surveys at the beginning of the semester. Past month alcohol use, cannabis use, and reinforcement from alcohol-free and alcohol-involved activities were assessed. A zero-inflated Poisson regression was used to test the association between proportionate alcohol-free reinforcement and days of co-use. The results indicated that proportionate alcohol-free reinforcement was negatively associated with co-use days in the count model when controlling for alcohol use days and gender as covariates (β: -3.28, p = 0.016). Proportionate alcohol-free reinforcement did not significantly differentiate individuals who did not engage in co-use in the zero-inflated model (β: -1.68, p = 0.497). The study suggested that greater proportionate alcohol-free reinforcement may be associated with lower engagement in the co-use of alcohol and cannabis among young adults. Increasing engagement in alcohol-free sources of reinforcement may be considered a target for co-use prevention or harm reduction efforts.

Interest in and perceived effectiveness of contingency management among alcohol drinkers using behavioral economic purchase tasks

Contingency management (CM), in which financial incentives are provided upon verification of abstinence from alcohol, cigarettes, and/or illicit substances, is one of the most highly effective and empirically supported treatments for substance use disorders. However, the financial cost of implementation has been identified as a major barrier to implementation of this treatment. The purpose of this study was to develop behavioral economic purchase tasks to assess interest in CM as a function of treatment cost and perceived effectiveness of CM as a function of abstinence incentive size in alcohol drinkers. Alcohol drinkers recruited from Amazon Mechanical Turk (MTurk) completed behavioral economic purchase tasks measuring demand for CM based on targeted abstinence intervals and treatment effectiveness and alcohol use disorder severity assessments. Nonlinear mixed-effects modeling was used to fit demand curves and assess the relationship between individual characteristics and demand metrics for CM. Results reveal that participants reported higher probability of remaining abstinent from drinking when offered larger incentives and required larger incentives when duration of abstinence required to earn the incentive was increased. Additionally, willingness to pay for treatment increased as effectiveness of treatment increased. Abstinence interval and treatment effectiveness are important features to consider when developing effective CM for widespread use, as these variables affected participants' likelihood of being abstinent and their interest in treatment. Future work will validate these assessments with actual treatment outcomes and determine predictors of CM treatment effectiveness. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Using crowdsourcing to study the differential effects of cross-drug withdrawal for cigarettes and opioids in a behavioral economic demand framework

Smoking rates among those who use prescribed or recreational opioids are significantly higher than the general population. Hypothesized neuropharmacological interactions between opioids and nicotine may contribute to this pattern of polysubstance use, especially during withdrawal. However, little research has examined how the withdrawal of one substance may affect the consumption of the other (i.e., cross-drug withdrawal effects). Behavioral economic demand tasks (e.g., hypothetical purchase tasks) can be used to quickly assess the value of a drug. Crowdsourcing can be a convenient tool to gain preliminary insight into different processes in substance valuation that may otherwise be impossible or prohibitively difficult to study. The purpose of the present study was to provide a preliminary examination of the effects of hypothetical withdrawal of cigarettes and opioids on the consumption of those drugs among polysubstance users. Amazon Mechanical Turk workers who reported daily smoking and at least monthly opioid use completed a series of hypothetical purchase tasks for doses of opioids and cigarettes under various withdrawal conditions. Sensitivity to the price of both drugs decreased when under withdrawal for either, indicating a higher drug value of cigarettes and opioids due to effects of cross-drug withdrawal. Nicotine and opioid dependence severity, impulsive choice, and riskiness were also positively related to drug purchasing. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Behavioral economic interactions between cannabis and alcohol purchasing: Associations with disordered use

As cannabis policy changes, there is an urgent need to understand interactions between cannabis and alcohol couse. An online sample of 711 adult past-month cannabis and alcohol users completed both single-item hypothetical purchasing tasks for cannabis and alcohol and cross-commodity purchasing tasks assessing adjusting-price cannabis with concurrently available, fixed-price alcohol, and vice versa. Participants provided information about cannabis and alcohol use patterns, and completed the Alcohol and Cannabis Use Disorder Identification Tests (AUDIT and CUDIT, respectively). Group data showed that cannabis and alcohol served as complements (as the price of the adjusting-price commodity increased, consumption of both commodities decreased). However, individual data showed substantial variability with nontrivial proportions showing patterns of complementarity, substitution, and independence. More negative slopes (greater complementarity) for fixed-price cannabis and alcohol were both associated with greater self-reported drug consumption and CUDIT and AUDIT scores. The negative relation between cross-price slope and CUDIT/AUDIT score indicates that individuals who treat cannabis and alcohol more as complements are more likely to experience disordered use. Based on these cross-commodity purchasing data, when both cannabis and alcohol are concurrently available at low prices, both may be used at high levels, whereas limiting consumption of one commodity (e.g., through increased price) may reduce consumption of the other. These data show the importance of examining individual participant analyses of behavioral economic drug interactions and suggest that manipulation of cost (e.g., through taxes) or cosale restrictions are potential public health regulatory mechanisms for reducing alcohol and cannabis use and couse behaviors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A longitudinal approach to understanding risk factors for problem alcohol use during the COVID-19 pandemic

Background

We conducted a longitudinal study to examine person‐centered heterogeneity in problem drinking risk during the 2019 Coronavirus disease (COVID‐19) pandemic. We aimed to differentiate high‐ from low‐risk subgroups of drinkers during the pandemic, to report on the longitudinal follow‐up of the baseline sample reported in Wardell et al. (Alcohol Clin Exp Res, 44, 2020, 2073), and to examine how subgroups of drinkers differed on coping‐related and pre‐pandemic alcohol vulnerability factors.

Methods

Canadian alcohol users (N = 364) were recruited for the study. Participants completed surveys at four waves (spaced 3 months apart), with the first being 7 to 8 weeks after the COVID‐19 state of emergency began in Canada. The data were analyzed using a parallel process latent growth class analysis followed by general linear mixed models analysis.

Results

We found evidence for three latent classes: individuals who increased drinking (class 1; n = 23), low‐risk drinkers (class 2; n = 311), and individuals who decreased drinking (class 3; n = 30). Participants who increased (vs. those who decreased) problem drinking during the pandemic struggled with increasing levels of social disconnection and were also increasingly more likely to report drinking to cope with these issues. Those in the increasing class (relative to low‐risk drinkers) reported increasing levels of depression during the study. Relative to low‐risk drinkers, participants in the increasing class had higher pre‐pandemic AUDIT scores, greater frequency of solitary drinking, and higher alcohol demand. Interestingly, participants in the decreasing class had the highest pre‐pandemic AUDIT scores.

Conclusions

We examined longitudinal data to identify subgroups of drinkers during the pandemic and to identify factors that may have contributed to increased problem drinking. Findings suggest that while most of the sample did not change their alcohol use, a small portion of individuals escalated use, while a small portion decreased their drinking. Identifying the vulnerability factors associated with increased drinking could aid in the development of preventative strategies and intervention approaches.

Concurrent validity of the Alcohol Purchase Task for measuring the reinforcing efficacy of alcohol: an updated systematic review and meta-analysis

BACKGROUND AND AIMS

An early meta-analysis testing the concurrent validity of the Alcohol Purchase Task (APT), a measure of alcohol's relative reinforcing value, reported mixed associations, but predated a large number of studies. This systematic review and meta-analysis sought to: (1) estimate the relationships between trait-based alcohol demand indices from the APT and multiple alcohol indicators, (2) test several moderators and (3) analyze small study effects.

METHODS

A meta-analysis of 50 cross-sectional studies in four databases (n = 18 466, females = 43.32%). Sex, year of publication, number of APT prices and index transformations (logarithmic, square root or none) were considered as moderators. Small study effects were examined by using the Begg-Mazumdar, Egger's and Duval & Tweedie's trim-and-fill tests. Alcohol indicators were quantity of alcohol use, number of heavy drinking episodes, alcohol-related problems and hazardous drinking. APT indices were intensity (i.e. consumption at zero cost), elasticity (i.e. sensitivity to increases in costs), O_max (i.e. maximum expenditure), P_max (i.e. price associated to O_max ) and breakpoint (i.e. price at which consumption ceases).

RESULTS

All alcohol demand indices were significantly associated with all alcohol-related outcomes (r = 0.132-0.494), except P_max , which was significantly associated with alcohol-related problems only (r = 0.064)_. The greatest associations were evinced between intensity in relation to alcohol use, hazardous drinking and heavy drinking and between O_max and alcohol use. All the tested moderators emerged as significant moderators. Evidence of small-study effects was limited.

CONCLUSIONS

The Alcohol Purchase Task appears to have concurrent validity in alcohol research. Intensity and O_max are the most relevant indices to account for alcohol involvement.

Trajectories of reward availability moderate the impact of brief alcohol interventions on alcohol severity in heavy-drinking young adults

BACKGROUND

Behavioral economic theory predicts that low access to environmental reward is a risk factor for alcohol use disorder (AUD). The Substance-Free Activity Session (SFAS) is a behavioral economic supplement to standard brief alcohol interventions that attempts to increase environmental reward and may therefore have beneficial effects, particularly for individuals with low levels of environmental reward.

METHODS

Participants were 393 college students who reported at least 2 heavy-drinking episodes in the past month. Participants were randomly assigned to 1 of 3 conditions following a baseline assessment: a standard alcohol-focused brief motivational intervention plus relaxation training session (BMI + RT), BMI plus Substance-Free Activity Session (BMI + SFAS), or an assessment-only control condition (AO). In a secondary analysis of the data from this study, we used person-centered statistical techniques to describe trajectories of alcohol severity and environmental reward over a 16-month follow-up and examined whether environmental reward levels moderated the effectiveness of the interventions.

RESULTS

Piecewise growth mixture modeling identified 2 trajectories of reward availability: low increasing (LR; n = 120) and high stable (HR; n = 273). Depressive symptoms, cannabis use, sensation seeking, and low life satisfaction were associated with a greater probability of classification in the LR trajectory. Alcohol severity was greater in the LR trajectory than the HR trajectory. For students in the LR trajectory, at 1, 6, and 12 months, BMI + SFAS led to greater increases in reward availability and reduced levels of alcohol severity compared with the BMI + RT and AO conditions and at 16 months compared with AO.

CONCLUSIONS

Young adults with low levels of environmental reward are at heightened risk for greater alcohol severity and may show greater benefit from brief alcohol interventions that focus on increasing substance-free reward than individuals who are not deficient in reward availability.

Statistically derived patterns of behavioral economic risk among heavy-drinking college students: A latent profile analysis

High levels of 3 behavioral economic indices (delay discounting, alcohol demand, and proportionate substance-related reinforcement) are consistently associated with greater alcohol misuse and alcohol-related problems. However, it is unclear whether and how these variables jointly increase the risk for alcohol-related outcomes among college students who engage in heavy episodic drinking (HED; 4/5+ drinks for women/men, respectively). The current study used a person-centered approach to identify similar patterns of behavioral economic domains among heavy-drinking college students and investigate the relationship between these empirically derived classes and alcohol-related outcomes. A sample of 393 college students (60.8% female, 78.9% White/Caucasian) reporting at least 2 heavy drinking episodes in the previous month completed measures of alcohol use and problems, demographics, delay discounting, and alcohol reward value (alcohol demand and proportionate substance-related reinforcement). Latent profile analyses revealed that a 3-class solution provided the best fit to the data: a low reward value, high discounting (LRHD) class (n = 53), a moderate reward value, low discounting (MRLD) class (n = 214), and a high reward value, high discounting (HRHD) class (n = 126). Members of the HRHD class reported significantly greater alcohol consumption, past-month HED episodes, alcohol-related problems, and symptoms of alcohol use disorder than those in the MRLD and LRHD classes. The results suggest that there are 3 constellations of behavioral economic processes and that, consistent with the reinforcer pathology model, students who overvalue alcohol-related reward and discount the future more steeply are at the greatest risk for alcohol misuse and alcohol-related problems. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Behavioral economics and the aggregate versus proximal impact of sociality on heavy drinking

BACKGROUND

Behavioral economic theory predicts decisions to drink are cost benefit analyses, and heavy episodic drinking occurs when benefits outweigh costs. Social interaction is a known benefit associated with alcohol use. Although heavy drinking is typically considered more likely during more social drinking events, people who drink heavily in isolation tend to report greater severity of use. This study explicitly disaggregates between-person and within-person effects of sociality on heavy episodic drinking and examines behavioral economic moderators.

METHODS

We used day-level survey data over an 18-week period in a community adult sample recruited through crowdsourcing (mTurk; N = 223). Behavioral economic indices were examined to determine if macro person-level variables (alcohol demand, delay discounting, proportionate alcohol-related reinforcement [R-ratio]) interact with event-level social context to predict heavy drinking episodes.

RESULTS

Mixed effect models indicated significant between-person and within-person social context associations. Specifically, people with a higher proportion of total drinking occasions in social contexts had decreased odds of heavy drinking, whereas being in a social context for a specific drinking occasion was associated with increased odds of heavy drinking. Person-level R-Ratio, demand elasticity, and breakpoint variables interacted with social context to predict heavy episodic drinking, such that the event-level social context association was stronger when R-Ratios, alcohol price insensitivity, and demand breakpoints were high.

CONCLUSIONS

These results demonstrate an ecological fallacy, in which the size and direction of effects were divergent at different levels of analysis, and highlight the potential for merging behavioral economic variables with proximal contextual effects to predict heavy drinking.

The Effects of Anger on Alcohol Demand and Subjective Alcohol Craving

BACKGROUND

Anger and anger-related traits have been related to alcohol use in both cross-sectional and prospective studies. However, only a small number of studies have experimentally manipulated anger to examine whether the manipulation of anger influences alcohol craving or the relative reinforcing value of alcohol.

METHODS

Participants (N = 231) recruited through Amazon's MTurk were randomly assigned to a provocation condition or a neutral condition prior to completing both the Alcohol Purchase Task and a self-report measure of alcohol craving. Linear regression analyses were conducted to examine the effects of the anger induction, trait hostility, frequency of alcohol use in the past month, and relevant demographic characteristics (gender, age, income) on alcohol craving and indices of alcohol demand.

RESULTS

Participants assigned to the provocation condition had greater P_Max (B = 0.17, p = 0.012) and breakpoint (B = 0.18, p = 0.006) values, less elastic demand (B = -0.15, p = 0.020), and lower drinking intensity (B = -0.14, p = 0.025) than participants assigned to the neutral condition. Trait hostility was positively related to O_Max (B = 0.22, p = 0.001), intensity of demand (B = 0.27, p < 0.001), and subjective alcohol craving posttask (B = 0.32, p < 0.001), but did not moderate the relationship between condition and outcomes.

CONCLUSIONS

Although most persistence indices of alcohol demand were sensitive to the anger induction, we did not observe higher scores on amplitude indices or subjective craving in the provocation condition relative to the neutral condition. Further investigation into the role which anger plays in alcohol use is warranted.

Using Demand Curves to Quantify the Reinforcing Value of Social and Solitary Drinking

BACKGROUND

Young adults typically drink in social settings and report high levels of episodic heavy drinking despite a range of adverse consequences. Behavioral economics posits that this may reflect a reinforcer pathology in which alcohol is overvalued relative to other reinforcers. Theoretically, the value of alcohol is related to both the direct pharmacological effects of alcohol (euphoria, sedation) and the associated social reinforcement, but to date no studies have differentiated the value of social vs. solitary drinking. The current study examines two modified hypothetical alcohol purchase tasks (APTs), one explicitly social and one explicitly solitary, in order to quantify the reward value of social vs. solitary drinking and to determine whether there are unique clinical correlates of solitary alcohol demand.

METHODS

Participants were young adults (N = 274, Mage  = 25.15, SD = 4.10) recruited from Mturk and from a university subject pool. Participants completed a solitary and social APT, in addition to measures of alcohol consumption and problems.

RESULTS

Participants reported significantly greater demand in the social APT compared to the solitary APT across all demand indices. Elevated solitary and social demand were associated with elevated levels of alcohol use and problems. Using a residualized change approach, solitary demand amplitude (maximum consumption and expenditure) and persistence (price sensitivity) contributed additional variance above and beyond their social APT composite counterparts in predicting typical drinks per week and the self-care, academic/occupational, and physical dependence subscales of the YAACQ.

CONCLUSIONS

The presence of peers increases alcohol demand compared to a solitary scenario, and greater relative solitary drinking demand may be a risk factor for greater alcohol consumption and problems.

Behavioral economics and coping-related drinking motives in trauma exposed drinkers: Implications for the self-medication hypothesis

Behavioral economic theory can help researchers understand complex behavior by considering the availability and economic value associated with an individual's choices. This study explored how behavioral economic constructs relate to alcohol consumption and alcohol problems in a sample of trauma-exposed young adults. We further explored whether these behavioral economic constructs explained unique variance in alcohol outcomes beyond coping-related drinking motives. Participants were 91 trauma-exposed young adults who reported recent alcohol consumption (M_age = 26.53, female = 36.26%, non-White = 41.75%). Participants were recruited through Amazon Mechanical Turk. Questionnaires measured alcohol consumption, problems, and motives for use, as well as alcohol demand, delay discounting, future orientation, and access to environmental reward. Future orientation (ΔR2 = .05, p = .03) and delay discounting (ΔR2 = .04, p = .05) explained unique variance in alcohol problems after controlling for coping-related drinking motives. Further, alcohol demand indices (ΔR2s = .04-.10, ps = .00-.05) explained unique variance in alcohol consumption after controlling for coping-related drinking. Both coping motives and behavioral economic variables contribute to alcohol consumption and alcohol-related consequences among trauma-exposed young adults. Findings suggest that, beyond coping motives, behavioral economics may play a meaningful role in understanding alcohol misuse. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Experimental manipulations of behavioral economic demand for addictive commodities: a meta-analysis

BACKGROUND AND AIMS

Reinforcing value, an index of motivation for a drug, is commonly measured using behavioral economic purchase tasks. State-oriented purchase tasks are sensitive to phasic manipulations, but with heterogeneous methods and findings. The aim of this meta-analysis was to characterize the literature examining manipulations of reinforcing value, as measured by purchase tasks and multiple-choice procedures, to inform etiological models and treatment approaches METHODS: A random-effects meta-analysis of published findings in peer-reviewed articles. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol, studies were gathered through searches in PsycINFO and PubMed/MEDLINE (published 22 May 2018). Searches returned 34 unique studies (aggregate sample n = 2402; average sample size = 68.94) yielding 126 effect sizes. Measurements included change (i.e. Cohen's d) in six behavioral economic indices (intensity, breakpoint, O_max , P_max , elasticity, cross-over point) in relation to six experimental manipulations (cue exposure, stress/negative affect, reinforcer magnitude, pharmacotherapy, behavioral interventions, opportunity cost).

RESULTS

Cue exposure (d range = 0.25-0.44, all Ps < 0.05) and reinforcer magnitude [d = 0.60; 95% confidence interval (CI) = 0.18, 1.01; P < 0.005] manipulations resulted in significant increases in behavioral economic demand across studies. Stress/negative affect manipulations also resulted in a small, significant increase in O_max (d = 0.18; 95% CI = 0.01, 0.34; P = 0.03); all other effect sizes for negative affect/stress were non-significant, albeit similar in size (d range = 0.14-0.18). In contrast, pharmacotherapy (d range = -0.37 to -0.49; Ps < 0.04), behavioral intervention (d = -0.36 to -1.13) and external contingency (d = -1.42; CI = -2.30, -0.54; P = 0.002) manipulations resulted in a significant decrease in intensity. Moderators (substance type) explained some of the heterogeneity in findings across meta-analyses.

CONCLUSIONS

In behavioral economic studies, purchase tasks and multiple-choice procedures appear to provide indices that are sensitive to manipulations found to influence motivation to consume addictive substances in field experiments.

Utilizing the commodity purchase task to evaluate behavioral economic demand for illicit substances: a review and meta-analysis

BACKGROUND ANDAIMS

The commodity purchase task is a simulated demand procedure that is easy and quick to complete (< 5 minutes) as well as adaptable for remote delivery and use with varied study populations. The purpose of this meta-analysis was to synthesize research using the commodity purchase task with illicit substances to evaluate the magnitude of omnibus effects sizes and moderators of the correlation of demand indices with quantity-frequency (QF) and severity measures.

DESIGN

Random-effects meta-analyses and meta-regressions involving studies with cross-sectional correlational designs.

SETTING AND PARTICIPANTS

Eleven studies, 10 outcomes and 2146 participants from two countries (USA and UK) published up to 1 October 2018.

MEASUREMENTS

Omnibus effect sizes (correlation coefficients) of five demand indices from the commodity purchase task [intensity (unconstrained consumption), elasticity (price sensitivity), O_max (maximum expenditure), P_max (price at maximum expenditure) and breakpoint (first price of zero consumption)] with QF and severity measures. Meta-regression models tested moderators of effect sizes (i.e. sample age and sex composition, commodity type and number of prices used in the commodity purchase task).

FINDINGS

Significant omnibus effect sizes were observed with QF and severity measures for intensity (r = 0.32/0.28, QF/severity, respectively), elasticity (r = -0.14/-0.18), O_max (r = 0.30/0.29) and breakpoint (r = 0.17/0.22) values. P_max was only significantly associated with severity measures (r = 0.15). The percentage of female participants and number of prices used in the purchase task significantly moderated P_max and breakpoint effect-size estimates in that stronger associations were observed in samples with a greater percentage of women and in studies using tasks with more price points. Commodity type (cannabis versus cocaine) did not significantly moderate associations involving any demand index.

CONCLUSIONS

Behavioral economic demand as measured by the commodity purchase task is consistently correlated with measures of illicit substance use quantity-frequency and severity.

Leveraging crowdsourcing methods to collect qualitative data in addiction science: Narratives of non-medical prescription opioid, heroin, and fentanyl use

BACKGROUND

Online crowdsourcing methods have proved useful for studies of diverse designs in the behavioral and addiction sciences. The remote and online setting of crowdsourcing research may provide easier access to unique participant populations and improved comfort for these participants in sharing sensitive health or behavioral information. To date, few studies have evaluated the use of qualitative research methods on crowdsourcing platforms and even fewer have evaluated the quality of data gathered. The purpose of the present analysis was to document the feasibility and validity of using crowdsourcing techniques for collecting qualitative data among people who use drugs.

METHODS

Participants (N = 60) with a history of non-medical prescription opioid use with transition to heroin or fentanyl use were recruited using Amazon Mechanical Turk (mTurk). A battery of qualitative questions was included indexing beliefs and behaviors surrounding opioid use, transition pathways to heroin and/or fentanyl use, and drug-related contacts with structural institutions (e.g., health care, criminal justice).

RESULTS

Qualitative data recruitment was feasible as evidenced by the rapid sampling of a relatively large number of participants from diverse geographic regions. Computerized text analysis indicated high ratings of authenticity for the provided narratives. These authenticity percentiles were higher than the average of general normative writing samples as well as than those collected in experimental settings.

CONCLUSIONS

These findings support the feasibility and quality of qualitative data collected in online settings, broadly, and crowdsourced settings, specifically. Future work among people who use drugs may leverage crowdsourcing methods and the access to hard-to-sample populations to complement existing studies in the human laboratory and clinic as well as those using other digital technology methods.

Sensitivity of hypothetical purchase task indices when studying substance use: A systematic literature review

Hypothetical Purchase Tasks (HPTs) simulate demand for a substance as a function of escalating price. HPTs are increasingly used to examine relationships between substance-related correlates and outcomes and demand typically characterized using a common battery of indices (Intensity, Omax, Pmax, Breakpoint, Elasticity). This review examines the relative sensitivity of the HPT indices. Reports were identified using the search term "purchase task" in PubMed and Web of Science. For inclusion, reports had to be original studies in English, examine relationships between HPT indices and substance-related correlates or outcomes, and appear in a peer-reviewed journal through December 2017. Indices were compared using effect sizes (Cohen's d) and the proportion of studies in which statistically significant relationships were observed. The search identified 1274 reports with 114 (9%) receiving full-text review and 82 (6%) meeting inclusion criteria. 41 reports examined alcohol, 34 examined cigarettes/nicotine products, and 10 examined other substances. Overall, statistically significant relationships between HPT indices and substance-related correlates and outcomes were most often reported for Intensity (88.61%, 70/79), followed by Omax (81.16%, 56/69), Elasticity (72.15%, 57/59), Breakpoint (62.12%, 41/66), and Pmax (48.08%; 25/52). The largest effect sizes were observed for Intensity (0.75 ± 0.04, CI 0.67-0.84) and Omax (0.64 ± 0.04, CI 0.56-0.71), followed by Elasticity (0.44 ± 0.04, CI 0.37-0.51), Breakpoint (0.30 ± 0.03, CI 0.25-0.36), and Pmax (0.25 ± 0.04, CI 0.18-0.33). Patterns were largely consistent across substances. In conclusion, HPTs can be highly effective in revealing relationships between demand and substance-related correlates and outcomes, with Intensity and Omax exhibiting the greatest sensitivity.

Using behavioral economic variables to predict future alcohol use in a crowdsourced sample

BACKGROUND

Theoretical perspectives at the intersection of behavioral economics and operant theory have resulted in numerous advances for addiction science. Three mechanisms (i.e. behavioral economic demand [consumption-price relationships], delay discounting [reinforcer devaluation with delay], and proportionate alcohol-related reinforcement [relative reinforcement attributable to alcohol]) are proposed to contribute to problematic alcohol use. Limited research has evaluated the unique contribution of these mechanisms for predicting future alcohol consumption.

AIM

The purpose of this study was to evaluate the predictive relationship between these mechanisms and self-reported alcohol use frequency, quantity, and severity.

METHODS

Participants (n=223) sampled from the crowdsourcing website Amazon Mechanical Turk completed a survey containing behavioral economic measures. Weekly reports of daily alcohol use were then collected for 18 weeks. Unadjusted and adjusted models determined the association between behavioral economic variables and alcohol use.

RESULTS/OUTCOMES

Behavioral economic measures were associated with alcohol and soda use at baseline in a stimulus-selective manner (e.g. alcohol demand associated with alcohol, but not soda, variables). Predictive models adjusted for Alcohol Use Disorder Identification Test scores indicated that increased proportionate alcohol-related reinforcement and behavioral economic demand were uniquely and incrementally associated with frequency (e.g. adjusted odds ratio (AOR)=5.54 for proportionate alcohol-related reinforcement, p<0.05) and quantity-severity measures (e.g. AOR=7.58 for alcohol demand intensity, p<0.001), respectively. Test-retest reliability was generally acceptable (r_xx=0.42-0.76) with the exception of proportionate alcohol-related reinforcement (r_xx=0.29).

CONCLUSION/INTERPRETATION

These findings indicate the unique, predictive, and incremental validity of behavioral economic measures for evaluating future alcohol consumption, supporting their continued use in addiction science research.

Measurement of substance-free reinforcement in addiction: A systematic review

A robust body of theoretical and experimental work highlights the influence of alternative, substance-free rewards on decisions to use alcohol and other drugs. However, translational applications have been limited in part by the lack of consensus on how to measure substance-free reinforcement in applied and clinical settings. The current study summarizes extant research utilizing self-report reinforcement or reward methodologies, and critically reviews the psychometric properties of the available measures. These studies (N = 50) fell into three categories: measures of recent substance-related and substance-free activity participation and enjoyment (n = 32), measures of time or monetary resource allocation (n = 15), and rating scale measures of reward availability and experience (n = 8). The available research suggests that, consistent with experimental laboratory research and with behavioral economic predictions, there is an inverse relation between substance-free reinforcement and substance use. These studies also support the clinical utility of these measures in predicting substance use severity and course. Reinforcement measures could be improved by enhancing content validity, multimethod convergent validity, and generalizability.

The R package beezdemand: Behavioral Economic Easy Demand

beezdemand: Behavioral Economic Easy Demand, a novel package for performing behavioral economic analyses, is introduced and evaluated. beezdemand extends the statistical program to facilitate many of the analyses performed in studies of behavioral economic demand. The package supports commonly used options for modeling operant demand and performs data screening, fits models of demand, and calculates numerous measures relevant to applied behavioral economists. The free and open source beezdemand package is compared to commercially available software (i.e., GraphPad Prism™) using peer-reviewed and simulated data. The results of this study indicated that beezdemand provides results consistent with commonly used commercial software but provides a wider range of methods and functionality desirable to behavioral economic researchers. A brief overview of the package is presented, its functionality is demonstrated, and considerations for its use are discussed.

Price elasticity of illegal versus legal cannabis: a behavioral economic substitutability analysis

BACKGROUND AND AIMS

The evolving legal status of cannabis world-wide necessitates evidence-based regulatory policies to minimize risks associated with cannabis misuse. A prominent concern is the impact legalization may have on the illegal cannabis market, including whether illegal cannabis will serve as a substitute for legal cannabis. Empirical data on this issue are virtually non-existent. This study used behavioral economics to investigate substitutability of legal and illegal cannabis in legalized catchment areas in the United States.

DESIGN

A substitution-based marijuana purchase task assessed estimated cannabis consumption from concurrently available legal (a dispensary) and illegal (a dealer) sources. Prices of the two options were reciprocally either held constant ($10/gram) or escalated ($0-$60/gram).

SETTING

US states with legalized recreational cannabis.

PARTICIPANTS

Adult cannabis users who were at least 21 years old (n = 724; mean age = 34.13; 52% female; 74% Caucasian) were recruited using online crowdsourcing.

MEASUREMENTS

Mean consumption values were used in demand curve modeling to generate indices of price sensitivity and elasticity. Differences in demand indices were compared using extra sums-of-squares F-tests.

FINDINGS

Both legal and illegal fixed-price cannabis options had significant positive cross-price elasticities (Ps < 0.001), indicating that higher prices motivate substitution irrespective of legality. However, the presence of a legal alternative had a substantially greater effect on consumption and elasticity of illegal cannabis (∆_elasticity  = 0.0019; F_(1,37)  = 160, P < 0.0001) than the presence of an illegal alternative on demand for legal cannabis (∆_elasticity  = 0.0002; F_(1,37)  = 48, P < 0.0001), indicating asymmetric substitution. Demand for legal cannabis was significantly greater than for illegal cannabis (P < 0.0001).

CONCLUSIONS

Cannabis users treat legal cannabis as a superior commodity compared with illegal cannabis and exhibit asymmetric substitutability favoring legal product. Cannabis price policies that include somewhat higher consumer costs for legal cannabis relative to contraband (but not excessively higher costs) would not be expected to incentivize and expand the illegal market.

Understanding alcohol motivation using the alcohol purchase task: A methodological systematic review

BACKGROUND

The Alcohol Purchase Task (APT) is a behavioral economic assessment of alcohol demand (i.e., motivation for consumption during escalating levels of response cost) using simulated marketplace survey techniques. While the APT is often used and widely cited, to date, there has yet to be a systematic review elucidating the variability in administering and analyzing the APT. The purpose of the current paper is to address this knowledge gap in the literature by cataloging the various purchase task methodologies and providing recommendations and future areas of inquiry.

METHODS

The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology was utilized (Prospero: No. CRD42017072159). Searches through Google Scholar, PsychINFO, PubMed, and SpringerLink databases identified 47 empirical articles referencing the use of an APT and published through the year 2016. Articles were coded for demographic and procedural characteristics, structural characteristics of the APT itself, and characteristics of data analysis.

RESULTS

Results indicate substantial variation within categories and suggest that there is no standard approach to administering the APT or analyzing the responses generated from it. The results underscore the need for researchers to report as much information as possible related to administration, instructions, price structuring, and analytical approach, as we found that many articles did not provide these details.

CONCLUSION

Enhancing the transparency of APT methods and analyses in published reports will aid in reproducibility as well as future meta-analytic studies of alcohol demand that could lead to the development of best-practice recommendations for this procedure.

Examination of approach and avoidance inclinations on the reinforcing value of alcohol

Although behavioral economics tends to focus on environmental factors (i.e., price, availability) that act to influence valuation of alcohol, recent research has begun to address how motivational and cognitive factors influence an individual's demand for alcohol. Motivational states, including craving, are one possible mechanism underlying the value based decision making that demand represents. Using a multidimensional model of craving (Ambivalence Model of Craving), the current study examined the relationships between indices of alcohol demand (i.e., reinforcing value of alcohol) and craving (i.e., approach inclinations), and the ways in which competing desires moderate that relationship (i.e., avoidance inclinations). Individuals who reported consuming alcohol in the past month were recruited for the study using Amazon's Mechanical Turk. A total of 529 participants (mean age=33.03years, SD=8.85) completed a series of surveys assessing their drinking behavior and other alcohol-related measures. Multiple regression analyses indicated that while approach significantly predicted intensity (i.e., consumption at zero cost), O_max (i.e., the maximum alcohol expenditure) and breakpoint (i.e., the first price that seizes consumption), avoidance moderated the relationship between approach and O_max and breakpoint. Specifically, follow up analyses demonstrated that higher avoidance inclinations attenuated the effect of approach inclinations on these demand indices. Finally, despite conceptual overlap between approach, avoidance, and alcohol demand, regression analyses indicated that these constructs account for unique variance in alcohol outcomes. These results illustrate the importance of considering the effects of both approach and avoidance inclinations on an individual's valuation of alcohol.

Protective behavioral strategies mediate the relationship between behavioral economic risk factors and alcohol-related problems

Behavioral economic measures of alcohol reward value and future orientation have received support as predictors of alcohol consumption, alcohol-related problems, and response to intervention. Protective behavioral strategies (PBS) have been shown to be a significant mediator between a variety of risk factors and alcohol-related problems. The current article examines direct and mediating associations between measures of alcohol reward value (proportionate substance-related activity participation and enjoyment) and future orientation, use of PBS, and alcohol-related problems. Participants were 393 undergraduates (39.2% male, 78.9% Caucasian) who reported at least 2 past-month binge drinking episodes (5 and 4 drinks for men and women, respectively). This study is a secondary analysis of data collected previously as part of a brief intervention study. Alcohol reward value and future orientation were significantly associated with both protective behavioral strategies and alcohol problems. PBS was a significant partial mediator between these variables and alcohol-related problems after controlling for gender, level of alcohol consumption, and sensation seeking. This study provides support for the hypothesis that high levels of reinforcement from alcohol relative to alternatives and low consideration of the future may lead to patterns of dysregulated drinking with few harm-reduction strategies that increase risk for alcohol problems. In addition to directly targeting PBS, brief alcohol interventions for college students should attempt to increase future orientation and substance-free activities. (PsycINFO Database Record